Remdesivir治疗新冠肺炎住院患者的有效性和安全性:一项卫生紧急时期单中心观察研究的现实生活数据倾向评分分析。

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Clinical Drug Investigation Pub Date : 2023-10-01 Epub Date: 2023-09-22 DOI:10.1007/s40261-023-01304-4
Nicola Ughi, Davide Paolo Bernasconi, Francesca Del Gaudio, Armanda Dicuonzo, Alessandro Maloberti, Cristina Giannattasio, Paolo Tarsia, Giovanna Travi, Francesco Scaglione, Fabrizio Colombo, Michaela Bertuzzi, Antonella Adinolfi, Maria Grazia Valsecchi, Claudio Rossetti, Oscar Massimiliano Epis
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引用次数: 0

摘要

背景和目的:Remdesivir是一种抗病毒药物,在治疗早期新冠肺炎方面被证明是安全有效的,但其对非危重症住院患者的有利影响仍在调查中。本研究旨在通过观察数据的倾向评分分析,评估瑞德西韦治疗新冠肺炎住院患者的有效性和安全性。方法:在这项单中心回顾性队列研究中,与仅护理标准相比,评估了与护理标准相关的5天疗程瑞德西韦(第1天静脉注射200 mg,第2-5天静脉注射100 mg)的有效性和安全性。主要终点是第14天的康复比例。结果:在入院时鼻咽拭子检测出严重急性呼吸综合征冠状病毒2基因组呈阳性的3662名符合条件的住院患者中,861名(24%)非危重患者被纳入倾向评分分析,281名(33%)患者暴露于瑞德西韦。总的来说,242/281(86.1%)和435/580(75.0%)患者在暴露和非暴露中分别康复,相对改善11.1%(95%CI+5.8-16.5%;未经调整的比值比:2.07,95%CI1.40-3.05,p=0.0001;通过倾向评分加权调整后,比值比:1.92,95%CI1.30-2.83,p=0.001),报告了1例(0.03%)药物注射过程中的过敏反应和1例(0.03%)急性反应,24例(8.5%)患者因不良反应停止治疗。次要疗效终点(住院全因死亡、需要重症监护治疗、第28天的临床改善分数)和安全性终点(任何和严重不良反应)没有发现显著差异住院患者,具有可接受的安全性。
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Effectiveness and Safety of Remdesivir in Treating Hospitalised Patients with COVID-19: A Propensity Score Analysis of Real-Life Data from a Monocentric Observational Study in Times of Health Emergency.

Background and objectives: Remdesivir is an antiviral agent, which was shown to be safe and effective in treating early COVID-19, but its favourable impact in hospitalised patients with non-critical disease is still under investigation. The present study aimed to assess the effectiveness and safety of remdesivir as a treatment for hospitalised patients with COVID-19 by a propensity score analysis of observational data.

Methods: In this monocentric retrospective cohort study, the effectiveness and safety of a 5-day course of remdesivir (200 mg intravenously at Day 1, then 100 mg from Days 2-5) in association with the standard of care were assessed in comparison with the standard of care only. The primary endpoint was the proportion of recovery on Day 14.

Results: Of 3662 eligible inpatients who tested positive for the severe acute respiratory syndrome coronavirus 2 genome by nasopharyngeal swab at admission, 861 (24%) non-critical patients were included in a propensity score analysis and 281 (33%) were exposed to remdesivir. In total, 242/281 (86.1%) and 435/580 (75.0%) patients recovered in exposed and non-exposed, respectively, with a relative improvement of 11.1% (95% CI + 5.8 to 16.5%; unadjusted odds ratio: 2.07, 95% CI 1.40-3.05, p = 0.0001; after adjustment by propensity score weighting, odds ratio: 1.92, 95% CI 1.30-2.83, p = 0.001). In treated patients, 1 (0.03%) anaphylactic reaction and 1 (0.03%) acute reaction during drug injection were reported, and 24 (8.5%) patients stopped the treatment due to adverse reactions. No significant differences were found with respect to the secondary efficacy endpoints (in-hospital all-cause death, need for intensive care treatments, clinical improvement score at Day 28) and safety endpoints (any and serious adverse reactions).

Conclusion: A 5-day course of remdesivir in association with the standard of care effectively promoted recovery from COVID-19 among non-critical in-hospital patients and had an acceptable safety profile.

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来源期刊
CiteScore
5.90
自引率
3.10%
发文量
108
审稿时长
6-12 weeks
期刊介绍: Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.
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